Background & Aims: In recent decades, much research has been conducted on attention deficit hyperactivity disorder, which brings more children to mental health centers than any other disorder. Attention deficit hyperactivity disorder is associated with many problems in various educational fields, low academic performance, low morale, aggression, dropping out of school, poor family and friendship relationships, anxiety, depression, and deficits in many skills. This disorder was first identified in 1845 by a German physician named Heinrich Hoffmann. Attention deficit hyperactivity disorder is a neurodevelopmental disorder characterized by three main features: attention deficit, hyperactivity, and impulsivity. This disorder is one of the most common neurobehavioral disorders of childhood that affects a large part of the world's population. People with this disorder may not be able to pay close attention to details or make careless mistakes in completing schoolwork, work, or other activities. Often, there is disorganization in performing activities and tasks are performed carelessly and without sufficient thought. It is often difficult for these people to maintain attention in games and homework, and they can hardly focus their attention to finish homework. Parents of children with attention deficit hyperactivity disorder experience more stress compared to parents of normal children, which can also lead to mental health problems for parents. Therefore, the purpose of this study was to compare the effectiveness of the positive parenting intervention program and mindfulness-based cognitive therapy on psychological fatigue in mothers of children with attention deficit/hyperactivity disorder in 2023.
Methods: This study was a quasi-experimental design with pre-test-post-test in the experimental group (positive parenting intervention program) and the comparison group (mindfulness-based cognitive therapy) with a control group and follow-up. The statistical population was all mothers of children with attention deficit/hyperactivity disorder referring to child clinics and psychiatrists in Kerman in 1402. The research sample consisted of 60 mothers of children with attention deficit/hyperactivity disorder, who were assigned to each group through purposive sampling and simple random allocation of 20 participants. The experimental group underwent positive parenting intervention and mindfulness-based cognitive therapy for a period of 12 75-minute sessions, and the control group did not receive the intervention. The research instrument was the Smetes Multidimensional Fatigue Questionnaire (1996).
Results: The results of the study showed that there was a statistically significant difference in the mean psychological fatigue scores of the positive parenting intervention program group and the mindfulness-based cognitive therapy group in the post-test phase using the analysis of covariance test. The positive parenting intervention program group had a greater effect on psychological fatigue than the mindfulness-based cognitive therapy group. Also, the significant difference between the positive parenting intervention program group and the control group and the mindfulness-based cognitive therapy group and the control group in the post-test phase confirms that each of the aforementioned groups alone had favorable effects on mothers' psychological fatigue.
Conclusion: In general, it can be concluded that a program of training mothers in safe parenting skills, such as explaining the child's developmental needs, parenting styles, teaching new skills, correcting difficult and problematic behaviors, learning how to establish an emotional and physical relationship with the child, and increasing awareness of problems and causes of problems, leads to the improvement of problematic and deviant behaviors, the creation of socially acceptable behaviors, and also changes parents' attitudes towards children's behavior. Fatigue means a mental feeling of weakness, lack of energy, and exhaustion that affects all aspects of people's lives and leads to a decrease in physical, social, and psychological functions, etc. Therefore, it can be stated that mothers' fatigue, which results from their isolation and isolation due to caring for children with disorders and inappropriate behaviors, will lead to stress in mothers. Increasing mothers' knowledge and skills by participating in this training program will help mothers gain a proper understanding of the nature of children's behavioral problems and appropriate behavioral practices with their children, learn how to control and contain their children's challenging behaviors, have a more positive attitude about their children's progress, and ultimately reduce their stress and worries about their children's conditions. Reducing stress and worry is undoubtedly effective in increasing assertive parenting and reducing strict and permissive practices. Explaining children's needs to mothers and familiarizing them with the effects of affection along with teaching positive and negative reinforcement can improve parents' awareness of the effects of effective parenting. On the other hand, teaching them to identify ineffective parental responses to children's misbehavior and correcting these behaviors will enable mothers to better control their misbehavior and try to replace it with effective behaviors. In complementing and reinforcing these educational strategies, mothers' familiarity with safe behavior makes them realize that behaviors such as ignoring the child, negativity, failure to respond to signals sent by the child, and intruding on the child's privacy are unsafe behaviors that result from an insecure attachment and that steps should be taken to correct these types of behaviors. In another explanation, the positive parenting skills training program increases emotional security in the child. This security, in turn, leads to the formation of a healthy relationship between the mother and child and plays a significant role in reducing ineffective parenting practices, followed by an increase in assertive parenting practices and reducing mothers' mental fatigue. The positive parenting skills training program causes parents to initiate relationships with their child and, after initiating relationships with their child, respond more positively to him/her, and in this way, they can become familiar with the consequences of safe behaviors.